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Western Growers · 2 months ago

Customer Service Representative I (Pacific/Mountain Time zone Based)

United States

Full-time

Remote

Entry Level

$35K/yr - $51K/yr

2+ years exp

Western Growers Health provides employer-sponsored health benefit plans for the agriculture industry. The Customer Service Representative I is responsible for responding to customer inquiries regarding insurance benefits and provider contracts, while also analyzing data to address operational challenges.

FinanceService Industry

Responsibilities

Respond to general customer questions via telephone, e-mail, and written correspondence regarding insurance benefits, provider contracts, eligibility, and claims in a confidential, professional, and ethical manner

Analyze problems and provide information/solutions

Research and resolve aged Customer Service open calls within company standards

Operate in the Health Care Processing System (HCPS), Imaging systems, and all systems necessary to obtain and extract information

Develop and maintain positive customer relations and coordinate with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner

Be accountable, when you uncover an issue or trend, for actually helping, assess and report what is happening in terms of impact, making improvements, and course correcting along the way

Thoroughly document information, activities, and changes in the database and inquiry outcomes for accurate tracking and analysis

Research and analyze data to address operational challenges and customer service issues

Provide external and internal customers with requested information, including difficult and upset customers

Meet and maintain Quality and Telephone Performance measures per Customer Service Performance Report

Communicate with the appropriate departments and identify service issues

Identify inefficiencies within the established processes and suggest possible solutions to save time, reduce risk, and/or reduce expenses

Create and document a minimum of one new Standard Operating Procedure (SOP) annually

Identify, initiate, and implement at least one process improvement and/or innovation annually

Maintain regular attendance per employee handbook guidelines

Utilize all capabilities to satisfy one mission — to enhance the competitiveness and profitability of our members. Do everything possible to help members succeed by being curious and striving to understand what others are trying to achieve, planning, and executing work helpfully and collaboratively. Be willing to adjust efforts to ensure that work and attitude are helpful to others, being self-accountable, creating a positive impact, and being diligent in delivering results

Maintain internet speed of 40 MB download and 10 MB upload and router with wired Ethernet

Maintain a HIPAA-compliant workstation and utilize appropriate security techniques to ensure HIPAA-required protection of all confidential/protected client data

Maintain and service safety equipment (e.g., smoke detector, fire extinguisher, first aid kit)

All other duties as assigned

Qualification

Customer service experienceHealth benefitsDatabase managementBilingual in SpanishProficient written communicationCommunication skillsOrganizational skillsTime management skillsAdaptability